Bone marrow (BM) endothelial progenitor cell (
EPC) damage of unknown mechanism delays the repair of endothelial cells (EC) and recovery of hematopoiesis after chemo-
radiotherapy. We found increased levels of the glycolytic
enzyme PFKFB3 in the damaged BM
EPC of patients with poor graft function, a clinical model of
EPC damage-associated poor hematopoiesis after allogeneic
hematopoietic stem cell transplantation. Moreover, in vitro the glycolysis inhibitor 3-(3-pyridinyl)- 1-(4-pyridinyl)-2-propen-1-one (3PO) alleviated the damaged BM
EPC from patients with poor graft function. Consistently, PFKFB3 overexpression triggered BM
EPC damage after
5-fluorouracil treatment and impaired hematopoiesis-supporting ability in vitro. Mechanistically, PFKFB3 facilitated pro-apoptotic
transcription factor FOXO3A and expression of its downstream genes, including p21, p27, and FAS, after
5-fluorouracil treatment in vitro. Moreover, PFKFB3 induced activation of NF-κB and expression of its downstream adhesion molecule
E-selectin, while it reduced hematopoietic factor SDF-1 expression, which could be rescued by FOXO3A silencing. High expression of PFKFB3 was found in damaged BM EC of murine models of chemo-
radiotherapy-induced myelosuppression. Furthermore, a murine model of BM EC-specific PFKFB3 overexpression demonstrated that PFKFB3 aggravated BM EC damage, and impaired the recovery of hematopoiesis after
chemotherapy in vivo, effects which could be mitigated by 3PO, indicating a critical role of PFKFB3 in regulating BM EC damage. Clinically, PFKFB3-induced FOXO3A expression and NF-κB activation were confirmed to contribute to the damaged BM
EPC of patients with acute
leukemia after
chemotherapy. 3PO repaired the damaged BM
EPC by reducing FOXO3A expression and phospho-NF-κB p65 in patients after
chemotherapy. In summary, our results reveal a critical role of PFKFB3 in triggering BM
EPC damage and indicate that endothelial-PFKFB3 may be a potential therapeutic target for myelosuppressive injury.